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Shenyang Military Region General Hospital completed the first by the apex TAVI surgery

Shenyang Military Region General Hospital completed the first by the apex TAVI surgery

  • Categories:News Channel
  • Author:
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  • Time of issue:2017-10-10 13:23
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(Summary description)

Shenyang Military Region General Hospital completed the first by the apex TAVI surgery

(Summary description)

  • Categories:News Channel
  • Author:
  • Origin:
  • Time of issue:2017-10-10 13:23
  • Views:
Information

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  ▌ September 28, Shenyang Military Region General Hospital Wang Huishan director of the team completed the first case of TAIV surgery.

 

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  Patient history data
  ▌ patients for a 71-year-old male, 10 years ago after the activities of chest tightness, shortness of breath, past a cerebral infarction, history of hypertension. Increased admission in January, the diagnosis of aortic stenosis and insufficiency. After discussion with the Heart Team, it was decided to use J-Valve? for TA-TAVI surgery.
  ▌CTA results show that the aortic valve two leaf type (type1), the valve is extremely calcified and eccentric distribution, left and right coronary sinus leaf junction at the junction of calcification, calcification lead to two leaf fusion. The heart has a diameter of 27.78mm. After evaluation and discussion, the Heart Team has decided to choose a 27mmJ-Valve?intervention valve.
  Surgery process
  ▌ surgery in the Shenyang Military Region General Hospital heart hybrid surgery room to complete the internal jugular vein placement of temporary pacing wire. DR to determine the location of the apex puncture, line 3cm minimally invasive incision. Suspension pericardium and apical purse suture. The femoral artery was implanted into the 6F sheath and the liver was placed in the pigtail catheter to the aortic root (ACT> 250s), and the optimal projection angle was obtained. Ultrasound and DR guided apex puncture, into the 1.8m J-Tip guide wire to the ascending aorta, into the vascular sheath, using JR4 catheter guide wire across the aortic arch to the descending aorta, replace the 2.6m plus hard guide wire.

 

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  1. Fast ventricular rate of 160 times, BSP 50mmHg when the balloon pre-expansion. As the calcification of the second line after the expansion of the balloon, the patient blood pressure 40mmhg, sudden ventricular fibrillation, defibrillation after the heart team to pacing heartbeat, to be stable in patients with disease continue to surgery, into the guide wire.
  2. through the apex into the intervention device, transported to the ascending aorta. Release the positioning key, and pull back to the three aortic valve sinus, angiography confirmed positioning key position is correct.
  3. Retract the valve, the stent valve under the guidance of the positioning key into the aortic valve area.
  4. Rotate release button, valve release (due to self-expanding valve, the whole process without RVP and any hemodynamic fluctuations).
  5. Recovery of the placement device, release of the valve, balloon after expansion, angiography and TEE showed acceptable flap leakage. Stitch the apical incision, the apex without bleeding, one by one to close the incision. Postoperative patients into the ccu ward, the indications stable.

 

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  Surgical summary
  ▌ hours after surgery, ventilator extubation, cardiac ultrasound showed valve flap disappeared, normal rhythm of blood pressure. 24 hours after leaving the ICU ward, into the general ward.
  ▌J-Valve? artificial interventional biological heart valve is a new generation of interventional valve, in April 2017 access to the State Food and Drug Administration approved clinical use, the indications include aortic stenosis, aortic valve insufficiency and aortic stenosis Merger is not complete, is the only one in the world to obtain official approval to treat aortic valve insufficiency of the interventional valve, but also aortic valve disease one-stop solution.

 

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